Individual provider Active NPI

Alexander Steven Gilmore, D.C.

  • Nutrition Chiropractor
  • Cedaredge, CO
National Provider Identifier
1902011489
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
5432 Issued in CO
Practice address
105 SE Greenwood Ave
Cedaredge, CO 81413-4003
Phone
(970) 856-3545
Fax
(970) 434-8501
NPI assigned
May 10, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 5432 CO Primary

Addresses

Primary practice location

105 SE Greenwood Ave
Cedaredge, CO 81413-4003

Mailing address

105 SE Greenwood Ave
Cedaredge, CO 81413-4003
Phone (970) 856-3545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120220000946 CO Practitioner - Chiropractic 6103715594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

105 SE Greenwood Ave
Cedaredge, CO 81413-4003
Phone (970) 856-3545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Total Family Wellness Inc. Nutrition CurrentSince Feb 1, 2003 Accepting new patients

Locations

105 SE Greenwood Ave
Cedaredge, CO 81413
Phone (970) 856-3545

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902011489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SE GREENWOOD AVE",
            "city": "CEDAREDGE",
            "state": "CO",
            "postal_code": "814134003",
            "telephone_number": "970-856-3545",
            "fax_number": "970-434-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SE GREENWOOD AVE",
            "city": "CEDAREDGE",
            "state": "CO",
            "postal_code": "814134003",
            "telephone_number": "970-856-3545",
            "fax_number": "970-434-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "ALEXANDER",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CO",
            "license": "5432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedaredge, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.